01908nas a2200277 4500000000100000008004100001260003700042653002400079653005700103653003400160653001900194100001300213700001600226700001400242700001300256700001100269700001500280700001000295700001600305245015000321856009900471300000800570490000700578520103100585022001401616 2023 d bPublic Library of Science (PLoS)10aInfectious Diseases10aPublic Health, Environmental and Occupational Health10aStop Mass Drug Administration10aonchocerciasis1 aBoakye D1 aMackenzie C1 aTallant J1 aHeggen A1 aLeff S1 aNadjilar L1 aSow M1 aBasáñez M00aEnhancing onchocerciasis elimination program management: A biological approach to deciding when to begin Stop Mass Drug Administration activities uhttps://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0011348&type=printable a1-80 v173 a

Understanding when it is the appropriate time to stop administering the drugs in a chemotherapy-centered treatment program such as onchocerciasis remains a challenge due to cost, imperfect testing procedures, and a lack of long-term experience. Different approaches for assessing when a program can begin the extensive stop-treatment surveys have been recommended, and tested, with varying results. We describe here a practical approach that is based on information on both transmission as well as infection. This new protocol first defines operational transmission zones (OTZs) based on vector breeding sites followed by an epidemiological assessment of the resident populations adjacent to these breeding sites. Basing decisions to stop MDA treatment based on breeding site locations (i.e., transmission zones) rather than on political administrative units, is a practical, cost-effective approach. Importantly, this biology-based approach is more closely related to the actual state of onchocerciasis transmission.

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